James Lab

Dr. James and colleagues will work with Southern Illinois Healthcare to address and improve the screening process and follow-up for patients who have a positive fecal blood test (FOBT, FIT). Research will begin by analyzing current procedures in 16 rural healthcare clinics and address ways to improve patient care. This analysis will provide information to establish and implement a successful multi-level intervention increasing CRC screening rates and follow-up care. Investigators at Washington University School of Medicine include Graham Colditz, MD, DrPH; Esther Lu, PhD; Jean Wang, MD; and Jean Hunleth, PhD, MPH. Colleagues at Southern Illinois Healthcare include Marci Moore-Connelly, MD; Kevin Oestmann, MD; Dan Skiles, Woody Thorne, Julie Patera, and Angie Bailey, and David Steward, MD, at Southern Illinois University School of Medicine.

This 3-year, $1.14 million grant from the National Institute on Minority Health and Health Disparities will build on previous work that found low-income patients used several strategies to cope with high medical costs and low financial resources. This project stemmed from Dr. James’ work with the Program for the Elimination of Cancer Disparities (PECaD) and the colon cancer community partnership. This grant will work with both patients and providers to discuss how patients cope with the high cost of medications and medical procedures and will lead to a pilot intervention to reduce cost-related nonadherence. The overall goal is to help improve health outcomes and reduce health disparities. Dr. James will work with co-investigators Jean Hunleth, PhD, MPH; Su-Hsin Chang, PhD; Cynthia Herrick, MD; and Amy McQueen, PhD.

Low-income rural communities experience significant cancer health disparities, including lower screening rates, increased incidence, later stage at detection, poorer survival, and higher mortality. The Southern Illinois University School of Medicine (SIUSM) and its Simmons Cancer Institute serve much of the central rural, southern rural, and Delta regions of Illinois. These rural communities have higher poverty rates and are medically underserved with disparately high cancer burden. SIUSM has established a partnership with the NCI-designated Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, and Siteman’s Prevention and Control Program.

This randomized controlled trial is part of our Community Networks Program funding (PECaD). This study is designed as a practical clinical trial, using community-based participatory research methods. We will work with health centers and local providers to identify potential systems-based interventions. Health centers randomized to the intervention will then have access to a menu of intervention strategies, and will receive assistance implementing their selected strategies. Control health centers will receive access to the intervention after the end of data collection. The main outcome is rate of CRC screening.

This project uses Photovoice methods and participatory research to engage community members in a study about facilitators and barriers to colon cancer screening, through the use of group and individual sessions and participant photography. Participants are given cameras and develop messages and ‘posters’ with messages to raise awareness of colon cancer and screening.

The photovoice project began in 2011 as a way to help promote awareness and begin discussions about colon cancer and preventative screenings. The project used a participant-driven approach in which community members are provided cameras to capture images relevant to colorectal cancer screening. Participating photos were shown to the public and integrated in PECaD community outreach activities.

The community-selected images and narratives gathered from this study have been built upon for future community-based studies and outreach to promote cancer screening and eliminate colorectal cancer disparities. In Spring 2016, Dr. James was awarded an additional grant based on the photovoice project. In addition, several papers have been published about the photovoice project and follow up grants have been established to continue addressing colorectal cancer disparities.

This project has been funded by the National Cancer Institute (R21 CA147794 PI- James).

The photos below represent some of the ways our participants chose to explain their journey with colon cancer.

This project’s goal is to establish the evidence base necessary to initiate future interventional studies of primary and secondary lower urinary tract symptoms (LUTS) prevention in adolescent girls and women. The grants activities include: 1) identification of risk factors for early-onset LUTS to allow prevention opportunities earlier in life; 2) confirmation of additional under-studied risk factors to expand opportunities for primary and secondary prevention; 3) synthesis of the existing literature to highlight research gaps and to help prioritize future research efforts; 4) establishment of normal voiding behaviors and function as a foundation for future interventions; and 5) determination of patient, provider, and structural barriers for LUTS prevention to maximize the reach and effectiveness of prevention strategies.

Pre-exposure Prophylaxis for HIV (PrEP) is an intensive strategy for HIV prevention among high risk individuals. It is over 92% effective, and real world implementation needs to be studied. PrEP implementation in a Medicaid non-expansion state has not been evaluated in the Midwest. This team will examine the insurance and cost variables associated with PrEP care and medication adherence at Washington University’s Infectious Disease Clinic’s PrEP Program, and then potentially expand portions of this project to PrEP project site partners in in Providence, Rhode Island and Jackson, Mississippi. The investigators will study the correlation of medication adherence and insurance status, and also conduct cost studies related to PrEP use and make inferences about barriers related to insurance status when looking PrEP care across three sites.

Young adult minority men who have sex with men (MSM) are one of the highest risk groups most likely to get new HIV infections in St. Louis. This population has also not adequately been engaged in HIV prevention research and, consequently, interventions. The project team will use social network analysis to determine ad placement for HIV prevention research on social apps. The study will include a survey component to solicit direct feedback about the advertising from users. Based on data gathered regarding high risk venues, affiliation networks using social network analysis will be generated in order to create a more accurate picture of effective study recruitment methods among minority MSM.

2010 James AS. Diet & Exercise: Trends in Cancer Intervention Research. Redes En Accion (The National Latino Cancer Research Network) National Steering Committee Meeting. San Antonio, TX.

2010 James AS. What really works to improve colorectal cancer screening rate – assessment and intervention to promote colon cancer screening in safety-net settings. Invited talk at the Quality Net Conference (CMS), Baltimore, MD.

2012 James AS. Implementing and Evaluating Community-Engaged Research. Invited talk at University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC.

2015 James AS. The Context of Cancer Prevention. Invited talk at the University of Nebraska Medical Center, Omaha, NE.

2016 James AS. Colorectal cancer screening and diagnostic services for urban and rural safety-net settings. American Association of Cancer Research – The Science of Cancer Disparities, Ft Lauderdale, FL.

2017 James AS. Implementation of cancer prevention in low-resource settings. Medical College of Wisconsin Cancer Center.

2020 James AS. Cancer Prevention and Control. Panel presentation at the American Society of Preventive Oncology – Associate Directors/Program Leaders Pre-Conference (Via Webinar)

2020 James AS. Financial Management in Academia for New Faculty. Part of : Junior Members Session 2: The Business of Research: Managing Time, Money, and People as a New PI. Invited presentation for the American Society of Preventive Oncology (via webinar).

2020 American Psychological Association – Presidential Panel on Psychologists working in Interdisciplinary Settings.

2010 James AS, Brewster M. Closing the Gap Between Research and Clinical Practice. Presentation at the Region V National Medical Association Meeting. Saint Louis, MO.

2012 James AS. Introduction to Qualitative Methods. Presentation for the KM1 Scholars Program at Washington University in St Louis.

2012 James AS. Mood effects of Exercise and Fitness. Presentation for the Women’s Health Symposium at Washington University (CME eligible).

2012 James AS, Chang S, Benesh E. Capturing the value added of transdisciplinary Science through the TREC Training Core. Presentation at the Transdisciplinary Research in Energetics and Cancer, External Advisory Board Meeting at Washington University in St Louis.

2012 James AS. Prostate cancer disparities in St Louis and the PECaD Program. Introductory presentation as part of the Cordonnier Visiting Professorship, Division of Urologic Surgery.

2013 James AS. Addressing Disparities in Colon Cancer. Siteman Cancer Center Panel Discussion: “Disparities Research: Where do we need to go from here?”.

2013 James AS. Colorectal Cancer: Getting Patients Screened. Gynecology and Obstetrics Grand Rounds, St Louis University School of Medicine.

2014 James AS. Balancing workload for productive research. Panel Discussion at the Southern Illinois University – Edwardsville Spring Symposium.

2014 James AS. Effective Community and Patient Engagement. Methods in PCOR Research and Comparative Effectiveness Research Symposium.

2018 Qualitative Research 101. Presentation to Family Planning Fellows, WUSM.

2020 Stress Management in the COVID-Area. Siteman Prevention and Control Week Programming.

2020 Future of Cancer Care – Ozarks Biomedical Institute Cancer Conference – Presentation and Break-out group Facilitation

2021 Implementing Cancer Screenings in Community Settings – Siteman Cancer Network Best Practice Form.

2021 Safety for Research Staff in Community and Clinical Research – Division of Public Health Sciences Friday Seminars

2008 Cancer Prevention Interventions. Presentation at the Regional Health Commission Community and Provider Advisory Board Meeting.

2010 “Health Promotion Issues Relevant to FAP”. Familial Adenomatous Polyposis Day at BJC West County Facility.

2010 Presentation of “Eight Ways to Stay Healthy”. YMCA Carondelet Park

2011 Presentation for “Live Life Aware” for Siteman Cancer Center. The Banquet Centers, Pevely, MO.

2011 Presentation for “Live Life Aware”. Siteman Cancer Center at Barnes-Jewish West County Hospital, Creve Coeur, MO.

2011 Presentation for “Live Life Aware”. Hilton Garden Inn, O’Fallon, MO.

2011 KSDK 8 ways phone bank events (repeated occasions)

2013 Colorectal Cancer Screening Update. Christian Hospital Northeast Grand Rounds

2013 Colorectal Cancer Screening Update. American Cancer Society, St Louis. (July 2013).

Preventing Colon Cancer. W. Jane Gee Memorial Colon Cancer Event, Normandy, MO

2015 Introduction to Research. PECaD Colon Cancer Community Education Day. Innovative Concept Academy, Saint Louis, MO.

2016 Understanding Research. PECaD/East St Louis Partnership Colon Cancer Community Education Day.

2017 James AS. Smart Health Cancer Educational Days. Chair. (St Louis and East St Louis)

2018 Colon Cancer Screening: Ensuring Patient Adherence. Metro East (St Louis) Cancer Conference. Belleville, IL.

2018 Improving Cancer Screenings: Lessons from the Field. Southern Illinois Cancer Action Network. Carterville, IL.

2018 James AS. SmartHealth Cancer Education Days Chair. (Christian Hospital in St Louis, and JJK Center, East St Louis, IL).

2019 James AS. 8 ways to reduce your risk for cancer. Presentation at SmartHealth at Christian Hospital

2019 James AS. 8 ways to reduce your risk for cancer. Presentation at SmartHealth at East St Louis City Hall

2020 8 Ways to Reduce your Risk for Cancer – Missouri Botanical Garden

2020 Pedal the Cause – COVID and Cancer Panel (2 sessions) 2021 Siteman Speaker Series – Colorectal Cancer Disparities and Activities